ISTITUTO ZOOPROFILATTICO SPERIMENTALE
DELLA LOMBARDIA E DELL'EMILIA ROMAGNA
“BRUNO UBERTINI”
------------------------------------Brescia, Via Bianchi n. 9 – 25124
Tel 03022901 – Fax 0302425251 – Email [email protected]
V.A.T. number 00284840170
To be completed by the IZSLER BVR:
ACCESSION NUMBER:
DATE RECEIVED:
ACCESSION FORM
To be completed by the Depositor:
CELL CULTURES OPEN DEPOSIT REQUEST FORM
Origin:
Species:
Type:
Cell Culture:
Growing Medium:
Freezing Medium:
Total cell/ml:
Morphology:
Karyotype:
Sterility Tests:
Virus Sensibility:
Biosafety Level:
Applications:
Control of Species:
Tissue/Organ:
1
Tumor:
Note:
Depositor Name:
Company/Institution:
Address:
City/State/Zip:
Phone:
Country:
E-Mail:
I understand that the material is for open deposit in the IZSLER BVR.
Distribution will be performed for research and laboratory test, at a fee to cover expenses.
Date ____/____/______ /Depositor Signature ______________________
BIOBANKING OF VETERINARY RESOURCES
ISTITUTO ZOOPROFILATTICO SPERIMENTALE DELLA LOMBARDIA E DELL’EMILIA ROMAGNA -WEB www.ibvr.org
VIA BIANCHI 9 - 25124 BRESCIA (ITALY) - TEL +39 030 2290536 - FAX +39 030 2290386 -E-MAIL [email protected]
VAT NUMBER IT: 00284840170
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